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Tuesday, 19 September 2017

The Relationship-Centred Care Approach



For almost a decade the care sector has been ‘promoting’ Person Centred Care in a bid to make themselves appear more ‘People friendly’ but what is Person Centred Care and why should we make a more permanent move towards Relationship Centred Care?

Person-centred care is a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs. This means putting people and their families at the centre of decisions and seeing them as experts, working alongside professionals to get the best outcome.

Person-centred care is not just about giving people whatever they want or providing information. It is about considering people’s desires, values, family situations, social circumstances and lifestyles; seeing the person as an individual, and working together to develop appropriate solutions.  Being compassionate, thinking about things from the person’s point of view and being respectful are all important. This might be shown through sharing decisions with patients and helping people manage their health, but person-centred care is not just about activities. It is as much about the way professionals and patients think about care and their relationships as the actual services available.

Despite this being the “adopted methodology” there remain widespread concerns about the quality of care Older People and their Families receive.

Responding appropriately to the health care needs of older people and those with long
standing conditions represents the greatest future challenge to health and social care
systems globally.

Relationship-centred care provides the underlying approach to deliver the best practice themes. It recognises the importance of positive relationships between older people, relatives and staff, as well as, between care homes, their local communities, and the wider health, social care and housing system.

It delivers 6 keys areas which under pin the Relationship:
·         a sense of security (to feel safe);
·         a sense of continuity (to experience links and connections);
·         a sense of belonging (to feel part of things);
·         a sense of purpose (to have a goal(s) to aspire to);
·         a sense of fulfilment (to make progress towards these goals); and
·         a sense of significance (to feel that you matter as a person).

Health and Social care is and has changed in fundamental ways over the last decade and longer. With the rise of the world wide web, people are becoming increasingly well informed, their expectations of services are rising, and they no longer have ‘blind trust’ in professional expertise. Service users and carers are actively seeking equal status and an empowered client or carer is potentially very threatening to professional carers.

While considerable policy emphasis has now been placed on creating partnerships between service providers, older people, and their family carers, the latter two groups still remained largely marginal figures in important decisions about their treatment and care and consequently, widespread concerns about the quality of care older people are receiving has grown.

So how do we make this move to Relationship-Centred Care?

The Edith Ellen Foundation believes that this can be achieved by Promoting quality care and quality services for older people.  By insisting that the emphasis is on developing services that reflect the wishes of users and carers, rather than the perceptions of care providers. However, while it is essential to consider what counts for older people and their family carers, we also believe that good quality care is unlikely to be achieved and sustained unless paid carers also enjoy and value their work. Ageist attitudes and the devaluing of work with older people are still all too apparent in both the health and social care systems.

Maslow's hierarchy of needs
Zero tolerance of poor care is best achieved via clearly communicated expectations in a supportive rather than punitive culture.  Promoting and maintaining best practice requires both personal commitment and organisational support, with a certain minimum level of resources.  This is a simplistic way but essential and purely based on Maslow's hierarchy of needs.

Through our own Project which we under took during 2015 – 2016 at a local Care Home in Norwich (UK), we were able to see the results of working towards Relationship-Centred Care we were able to ascertain the benefits of valuing care, the carer, the service user and their families.   

Most wanted by older people is person-centred care delivered by person-centred staff who are well motivated, well trained and who value their work. However, for people to value their work such work has also to be valued, both by society and by those in receipt of care.  Which why Relationship-Centred Care is the best policy to adopt.

Good care means recognising and valuing differing forms of expertise so that none is
privileged above the other. Professional carers must therefore value the expertise that
older people and family carers possess but this does not mean devaluing the central role of the outsider expert. 

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